Plasma Levels Of Vascular Endothelial Growth Factor Before And After Intravitreal Injection Of Bevacizumab Or Ranibizumab In The Treatment Of Neovascular Age-related Macular Degeneration

Abstract

Purpose: : To evaluate the vascular endothelial growth factor (VEGF) plasma levels in exudative age-related macular degeneration (AMD) patients before and after intravitreal injections of ranibizumab or bevacizumab and to compare them with age-matched controls.

Methods: : We studied forty-three exudative AMD patients and nineteen age-matched control patients. Nineteen patients were treated with intravitreal ranibizumab and twenty-four with intravitreal bevacizumab. Blood samples were collected in both groups just before the injections and 28 days after the loading dose. VEGF plasma levels were measured by ELISA.

Results: : The mean pre-treatment VEGF concentrations were significantly lower (p=0.05 for each group) in the control groups (162. 85 pg/ml) than in both the bevacizumab (243.63 pg/ml) and in ranibizumab groups (240.89 pg/ml). There was also a significant reduction in VEGF plasma levels twenty-eight days after the loading dose in bevacizumab-treated patients (p=0.00006); the mean reduction that did also occur at this time in the ranibizumab group did not achieve statistical significance (p=0.119). VEGF plasma levels after treatment in the bevacizumab group were similar to the controls (p=0.106).

Conclusions: : We found a significant reduction in VEGF plasma levels during the first 28 days after intravitreal bevacizumab injection in exudative AMD patients. Intravitreal Ranibizumab also accomplished VEGF reduction at the same time-point, but not to a level of statistical significance. This difference between intravitreal administration of the two drugs may render disctinct systemic safety profiles.

Keywords: age-related macular degeneration